MEDICARE: MS. MARIAH WINTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	PA.0007044	CO

General Provider Information

NPI Number	:	1730853581
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MARIAH WINTER

Provider Business Mailing Address
First Line	:	1939 SPRUCE CT
Second Line	:
City	:	ERIE
State	:	CO
Zip	:	80516-7977
Country	:	US
Telephone Number	:	720-378-2227
Fax Number	:

Provider Business Practice Location Address
First Line	:	403 SUMMIT BLVD UNIT 204
Second Line	:
City	:	BROOMFIELD
State	:	CO
Zip	:	80021-8253
Country	:	US
Telephone Number	:	720-401-2139
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/05/2021
Last Update Date	:	02/16/2026

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